The Brown University's Center for Gerontology and Health Care Research seeks to supplement its 25-year AHRQ-funded post-doctoral training program to include three additional post-doctoral training slots for Comparative Effectiveness Research (CER). Our Center's research focuses on diseases that impact the elderly, such as cancer, cardiovascular disease, and dementia. These conditions are among the leading causes of mortality and morbidity in the United States and account for a substantial proportion of national health care spending. Our research portfolio spans multiple settings (VA, hospitals, nursing homes, ambulatory facilities) and focuses on 1) Comparative effectiveness of cancer imaging;2) Clinical treatment choices for nursing home residents with dementia;3) Comparative effectiveness of states'Medicaid policies on important clinical outcomes;and 4) Comparisons of different insurance benefit designs on outcomes among Medicare managed care enrollees. We have obtained over $35 million to fund CER studies in these four areas. To facilitate this research agenda, we have built expertise in large-scale database analyses and cutting-edge analytic techniques, including complex multilevel models. These tools require an understanding of the interaction of biological, social, and behavioral factors. The training program emphasizes an individualized, competency-based approach rooted in matching fellows to mentors and their existing research. Fellows will take a leadership role on a major project as a member of an experienced research team, thereby benefiting our research data and project infrastructure. This proposed CER training initiative leverages our successful, long-standing post-doctoral training program, wide array of relevant available courses and seminars, and a vibrant and expanding research environment that has added new faculty for health services and externally-funded research. PUBLIC HEALTH RELEVANCE: Comparative Effectiveness Research (CER) is an important tool for the value-based purchasing of health care needed to "bend the cost curve." To apply CER to the growing number of areas of need, it is essential to have trained investigators in the field. Brown University has been training successful post-doctoral fellows in health services research for a quarter century and is poised to extend this effort to the special needs of CER.